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Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography

 Choongki Kim  ;  Byeong Keuk Kim  ;  Sung Jin Hong  ;  Chul Min Ahn  ;  Jung Sun Kim  ;  Young Guk Ko  ;  Donghoon Choi  ;  Myeong Ki Hong  ;  Yangsoo Jang 
 Yonsei Medical Journal, Vol.59(5) : 624-632, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adenosine/administration & dosage/*analogs & derivatives ; Aged ; Coronary Angiography ; *Drug-Eluting Stents/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; Neointima/*diagnostic imaging/*drug therapy ; Prospective Studies ; Prostheses and Implants ; Ticlopidine/administration & dosage/*analogs & derivatives ; Optical Coherence/*methods Tomography ; Treatment Outcome
Neointima ; clopidogrel ; myocardial infarction ; optical coherence ; ticagrelor ; tomography
PURPOSE: This study aimed to compare the effects of ticagrelor and clopidogrel on early neointimal healing assessed with optical coherence tomography (OCT) after drug-eluting stent (DES) implantation in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: AMI patients were randomly assigned to either the ticagrelor or clopidogrel arm. After DES implantation, OCT was performed to assess the percentages of uncovered struts immediately after procedure and 3 months later. RESULTS: Due to early termination, 83 patients out of 106 initially enrolled patients (24% of planned participants) underwent 3-month OCT. Differences in vascular healing patterns between the two groups, including percentage of uncovered struts on 3-month OCT (9.6% vs. 11.7% in ticagrelor vs. clopidogrel, respectively; p=0.867), neointimal thickness, percentage of malapposed struts, and healing scores did not reach statistical significance. The predictors of uncovered strut on 3-month OCT included greater reference vessel diameter [odds ratio (OR)=1.96, p<0.001] and more malapposed struts (OR=1.12, p=0.003). CONCLUSION: The current study did not explore favorable effect of ticagrelor on 3-month vascular healing after DES implantation. Our findings should only be considered for generating hypothesis, due to insufficient power.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk)
김병극(Kim, Byeong Keuk) ORCID logo https://orcid.org/0000-0003-2493-066X
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
김충기(Kim, Choong Ki)
안철민(Ahn, Chul-Min) ORCID logo https://orcid.org/0000-0002-7071-4370
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
홍명기(Hong, Myeong Ki) ORCID logo https://orcid.org/0000-0002-2090-2031
홍성진(Hong, Sung Jin) ORCID logo https://orcid.org/0000-0003-4893-039X
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